Novel galactoside inhibitors of galectins

ABSTRACT

Compounds having an effect as i.a. galectin inhibitors, to the use of said compounds as a medicament, as well as for the manufacture of a medicament for treatment of disorders relating to the binding of galectin to receptors in a mammal, wherein the galectin is preferably a galectin-3. The novel compounds are defined by the general formula:

TECHNICAL FIELD

The present invention relates to novel compounds, the use of said compounds as medicament and for the manufacture of a medicament for the treatment of any disorder relating to the binding of a galectin receptor in mammals. The invention also relates to pharmaceutical compositions comprising said novel compounds.

BACKGROUND ART

Galectins are proteins with a characteristic carbohydrate recognition domain (CRD) (Barondes et al., 1994; Leffler et al., 2004)(FIG. 1 a). This is a tightly folded β-sandwich of about 130 amino acids (about 15 kDa) with the two defining features 1) a β-galactose binding site (C in FIG. 1 a) and 2) sufficient similarity in a sequence motif of about seven amino acids, most of which (about six residues) make up the β-galactose binding site. However, adjacent sites (A, B, D, E in FIG. 1 a) are required for tight binding of natural saccharides and different preferences of these give galectins different fine specificity for natural saccharides.

The recent completion of the human, mouse and rat genome sequences reveal about 15 galectins and galectin-like proteins in one mammalian genome with slight variation between species (Leffler et al., 2004; Houzelstein et al., 2004).

Galectin subunits can contain either one or two CRDs within a single peptide chain. The first category, mono-CRDs galectins, can occur as monomers or dimers (two types) in vertebrates. The by far best studied galectins are the dimeric galectin-1, and galectin-3 that is a monomer in solution but may aggregate and become multimeric upon encounter with ligands (Leffler et al., 2004; Ahmad et al., 2004). These were the first discovered galectins and are abundant in many tissues. However, our recent phylogenetic analysis (FIG. 2) suggest that galectins with two CRDs within a peptide chain, bi-CRD galectins, appear to be more ancient and more central to the family than previously thought and that most of mammalian mono-CRD galectins may have descended from one or the other CRD of a bi-CRD galectin.

There are now over 2500 publications on galectins in PubMed, with most, as mentioned above, about galectins-1 (>600) and -3 (>1100). Strong evidence suggests roles for galectins in e.g. inflammation and cancer, and development recently reviewed in a special issue (Leffler (editor), 2004b).

Galectins are synthesized as cytosolic proteins, without a signal peptide on free ribosomes. Their N-terminus is acetylated, a typical modification of cytosolic proteins, and they reside in the cytosol for a long time (not typical of secreted proteins). From there they can be targeted to the nucleus, specific cytososlic sites, or secreted (induced or constitutively) by a non-classical (nonER-Golgi) pathway, as yet unknown, but possibly similar to the export of e.g. IL-1 (Leffler et al., 2004). They can also function in all these compartments; for galectin-3, solid evidence published in well respected journals support roles in RNA splicing in the nucleus, inhibition of apoptosis in the cytosol, and a variety of extracellular effects on cell signaling and adhesion (Patterson et al., Ochieng et al., Takenaka et al., Hsu et al. and others in Leffler (editor), 2004b). Galectin-7 and -12 also act in the cytosol by enhancing apoptosis and regulating the cell cycle and differentiation in certain cells (Hsu and Liu in Leffler (editor), 2004b). Most galectins act also extracellularly by cross-linking glycoproteins (e.g. laminin, integrins, and IgE receptors) possibly forming supramolecular ordered arrays (Brewer et al., 2002) and may thereby modulate cell adhesion and induce intracellular signals. Related to this, recent years have seen the emergence of a molecular mechanism of these galectin functions involving on formation of microdomains (lattices) within membranes, (Dam et al., 2008; Garner et al., 2008; Sacchettini et al., 2001) which in turn affects intracellular trafficking and cell surface presentation of glycoprotein receptors. (Delacour et al., 2007; Fortin et al., 2008; Lau et al., 2007; Lau et al. 2008) This has been documented in cell culture, in null mutant mice, (Blois et al., 2007; Gedronneau et al., 2008; Thijssen et al., 2007; Toscano et al., 2007; Saegusa et al., 2009) and animals treated with galectin (Blois et al., 2007; Perone et al., 2009) or galectin inhibitors. (John et al., 2003; Pienta et al., 1995; Glinsky et al., 1996)

The present invention relates mainly to galectin-1 inhibitors and galectin-3 inhibitors, but its principles may be applicable also to inhibitors of other galectins.

Potential Therapeutic Use of Galectin-3 Inhibitors

Galectin-3 has been implicated in diverse phenomena and, hence, inhibitors may have multiple uses. It is easy to perceive this as a lack of specificity or lack of scientific focus. Therefore, the analogy with aspirin and the cyclooxygenases (COX-I and II) is useful. The COXs produce the precursor of a wide variety of prostaglandins and, hence, are involved in a diverse array of biological mechanisms. Their inhibitors, aspirin and other NSAIDs (non-steroid anti-inflammatory drugs), also have broad and diverse effects. Despite this, these inhibitors are very useful medically, and they have several different specific utilities.

So if galectins, like COXs, are part of some basic biological regulatory mechanism (as yet unknown), they are likely to be ‘used by nature’ for different purpose in different contexts. Galectin inhibitors, like NSAIDs, are not expected to wipe out the whole system, but to tilt the balance a bit.

Inhibition of Inflammation

A pro-inflammatory role of galectin-3 is indicated by its induction in cells at inflammatory sites, a variety of effects on immune cells (e.g. oxidative burst in neutrophils, chemotaxis in monocytes), and decrease of the inflammatory response, mainly in neutrophils and macrophages, in null mutant mice (chapters by Rabinovich et al., Sato et al., and Almkvist et al. in Leffler (editor), 2004b). In particular, macrophage differentiation and fibrosis was recently shown to depend on galectin-3 and galectin-3 inhibitors were demonstrated to block macrophage differentiation and fibrosis-related molecular processes. (Mackinnon et al. 2008) Moreover, knock-out mice of Mac-2BP, a galectin-3 ligand, have increased inflammatory responses (Trahey et al., 1999). Inflammation is a protective response of the body to invading organisms and tissue injury. However, if unbalanced, frequently it is also destructive and occurs as part of the pathology in many diseases. Because of this, there is great medical interest in pharmacological modulation of inflammation. A galectin-3 inhibitor is expected to provide an important addition to the arsenal available for this.

Treatment of Septic Shock

The idea of a possible role of galectin-3 in septic shock comes from our own studies (Almquist et al., 2001). Briefly, the argument goes as follows. It is known that septic shock involves dissemination of bacterial lipopolysaccharide into the blood stream, and that the pathological effects of this are mediated via neutrophil leukocytes (Karima et al., 1999). LPS does not activate the tissue-damaging response of the neutrophil. Instead, it primes the neutrophil, so that it is converted from unresponsive to responsive to other, presumably endogenous, activators. In septic shock, this priming happens prematurely in the blood stream. Endogenous activators could then induce the tissue damaging response in the wrong place and time. Several candidates have been proposed as these endogenous activators, including TNF-alfa. Inhibitors of these have been used in treatment schemes without much success (Karima et al., 1999). Since our own studies indicate that galectin-3 is a good candidate for being an endogenous activator of primed neutrophils (Almquist et al., 2001), galectin-3 inhibitors may be very useful in septic shock.

Treatment of Cancer

A large number of immunohistochemical studies show changed expression of certain galectins in cancer (van den Brule et. al. and Bidon et al. in Leffler (editor), 2004b) Galectin-3 is now an established histochemical marker of thyroid cancer, and neoexpression of galectin-4 is a promising marker of early breast cancer (Huflejt and Leffler, 2004). The direct evidence for a role of galectin-3 in cancer comes from mouse models, mainly by Raz et al, but also others (Takenaka et al. in Leffler (editor), 2004b). In paired tumor cell lines (with decreased or increased expression of galectin-3), the induction of galectin-3 gives more tumors and metastasis and suppression of galectin-3 gives less tumors and metastasis. Galectin-3 has been proposed to enhance tumor growth by being anti-apoptotic, promote angiogenesis, or to promote metastasis by affecting cell adhesion. From the above it is clear that inhibitors of galectin-3 might have valuable anti-cancer effects. Indeed, saccharides claimed but not proven to inhibit galectin-3 have been reported to have anti-cancer effects. In our own study a fragment of galectin-3 containing the CRD inhibited breast cancer in a mouse model by acting as a dominant negative inhibitor (John et al., 2003). Furthermore, galectin inhibitors at nanomolar concentrations decreases tumor cell motility drastically and thus potentially increase sensitivity to conventional cytostatica.

Also galectin-1 is frequently over-expressed in low differentiated cancer cells, and galectin-9 or its relatives galectin-4 and galectin-8 may be induced in specific cancer types (Huflejt and Leffler, 2004; Leffler (editor), 2004b). Galectin-1 induces apoptosis in activated T-cells and has a remarkable immunosuppressive effect on autoimmune disease in vivo (Rabinovich et al; and Pace et al. in Leffler (editor), 2004b. Therefore, the over-expression of these galectins in cancers might help the tumor to defend itself against the T-cell response raised by the host (Rubinstein et al., 2004).

Null mutant mice for galectins-1 and -3 have been established many years ago (Poirier, 2002). These are healthy and reproduce apparently normally in animal house conditions. However recent studies have revealed subtle phenotypes in function of neutrophils and macrophages (as described above) and in bone formation for galectin-3 null mutants, and in nerve and muscle cell regeneration/differentiation for the galectin-1 null mutants (Leffler et al., 2004; Poirier, 2002; Watt in Leffler (editor), 2004b). Recently galectin-7 and galectin-9 null mutant mice have been generated and are also grossly healthy in animal house conditions, but have not yet been analyzed in detail. The differences in site of expression, specificity and other properties make it unlikely that different galectins can replace each other functionally. The observations in the null mutant mice would indicate that galectins are not essential for basic life supporting functions as can be observed in normal animal house conditions. Instead they may be optimizers of normal function and/or essential in stress conditions not found in animal house conditions. The lack of strong effect in null mutant mice may make galectin inhibitors more favorable as drugs. If galectin activity contributes to pathological conditions as suggested above but less to normal conditions, then inhibition of them will have less unwanted side effects.

Known Inhibitors Natural Ligands

Solid phase binding assays and inhibition assays have identified a number of saccharides and glycoconjugates with the ability to bind galectins (reviewed by Leffler, 2001 and Leffler et al., 2004). All galectins bind lactose with a K_(d) of 0.5-1 mM. The affinity of D-galactose is 50-100 times lower. N-Acetyllactosamine and related disaccharides bind about as well as lactose, but for certain galectins, they can bind either worse or up to 10 times better. The best small saccharide ligands for galectin-3 were those carrying blood group A-determinants attached to lactose or lacNAc-residues and were found to bind up to about 50 times better than lactose. Galectin-1 shows no preference for these saccharides.

Larger saccharides of the polylactosamine type have been proposed as preferred ligands for galectins. In solution, using polylactosamine-carrying glycopeptides, there was evidence for this for galectin-3, but not galectin-1 (Leffler and Barondes, 1986). A modified plant pectin polysaccharide has been reported to bind galectin-3 (Pienta et al., 1995).

The above-described natural saccharides that have been identified as galectin-3 ligands are not suitable for use as active components in pharmaceutical compositions, because they are susceptible to acidic hydrolysis in the stomach and to enzymatic degradation. In addition, natural saccharides are hydrophilic in nature, and are not readily absorbed from the gastrointestinal tract following oral administration.

Synthetic Inhibitors

Saccharides coupled to amino acids with anti-cancer activity were first identified as natural compounds in serum, but subsequently, synthetic analogues have been made (Glinsky et al., 1996). Among them, those with lactose or Gal coupled to the amino acid inhibit galectins, but only with about the same potency as the corresponding underivatized sugar. A chemically modified form of citrus pectin (Platt and Raz, 1992) that inhibits galectin-3 shows anti-tumor activity in vivo (Pienta et al., 1995; Nangia-Makker et al., 2002).

A divalent form of a lactosyl-amino acid had higher potency in a solid phase assay (Naidenko et al., 2000; Huflejt et al., 2001; Huflejt and Leffler, 2004) and clusters having up to four lactose moieties showed a strong multivalency effect when binding to galectin-3, but not to galectin-1 and -5 (Vrasidas et al., 2003). Cyclodextrin-based glycoclusters with seven galactose, lactose, or N-acetyllactosamine residues also showed a strong multivalency effect against galectin-3, but less so against galectins-1 and -7 (André et al., 2004). Starburst dendrimers (André et al., 1999) and glycopolymers (Pohl et al., 1999; David et al., 2004), made polyvalent in lactose-residues, have been described as galectin-3 inhibitors with marginally improved potency as compared to lactose. The aforementioned synthetic compounds that have been identified as galectin-3 ligands are not suitable for use as active components in pharmaceutical compositions, because they are hydrophilic in nature and are not readily absorbed from the gastrointestinal tract following oral administration.

Natural oligosaccharides, glycoclusters, glycodendrimers, and glycopolymers described above are too polar and too large to be absorbed and in some cases are large enough to produce immune responses in patients. Furthermore, they are susceptible to acidic hydrolysis in the stomach and to enzymatic hydrolysis. Thus, there is a need for small synthetic molecules

Thiodigalactoside is known to be a synthetic and hydrolytically stable, yet polar inhibitor, approximately as efficient as N-acetyllactosamine (Leffler and Barondes, 1986). A library of pentapeptides provided inhibitors against galectin-1 and -3, but only with low affinities, similar to that of galactose (Arnusch et al., 2004). Furthermore, peptides are not ideal agents for targeting galectins in vivo, as they are susceptible to hydrolysis and are typically polar. N-Acetyllactosamine derivatives carrying aromatic amides or substituted benzyl ethers at C-3″ have been demonstrated to be highly efficient inhibitors of galectin-3, with unprecedented IC₅₀ values as low as 4.8 μM, which is a 20-fold improvement in comparison with the natural N-acetyllactosamine disaccharide (Sörme et al., 2002; Sörme et al., 2003b). These derivatives are less polar overall, due to the presence of the aromatic amido moieties and are thus more suitable as agents for the inhibition of galectins in vivo. Furthermore, C3-triazolyl galactosides have been demonstrated to be as potent inhibitors as the corresponding C3-amides of some galectins. Hence, any properly structured galactose C3-substituent may confer enhanced galectin affinity.

However, said C3-amido- and C3-triazolyl-derivatised compounds are still susceptible to hydrolytic degradation in vivo, due to the presence of a glycosidic bond in the galactose and N-acetyllactosamine saccharide moiety and, although they are potent small molecule inhibitors of galectin-3, even further improved affinity and stability is desirable. Accordingly, inhibitors based on 3,3′-derivatization of thiodigalactoside have been developed, (Cumpstey et al., 2005; Cumpstey et al., 2008) which lack β-glycosidic hydrolytically and enzymatically labile linkages. These inhibitors also displayed superior affinity for several galectins (down to Kd in the low nM range). Nevertheless, although displaying high affinity for galectins, the 3,3′-derivatized thiodigalactosides still comprise of two galactose monosaccharide moieties that are too polar, resulting in poor absorption and rapid clearance, and too susceptible to enzymatic degradation.

Compounds of the prior art are known by the general formulas

in which second formula R¹ can be a D-galactose

Thus, due to the less than optimal pharmacokinetic properties of the compounds of the prior art, there is still a considerable need within the art of inhibitors against galectins, in particular of galectin-1 and galectin-3.

SUMMARY OF THE INVENTION

Therefore the present invention relates to a compound having the general formula (I):

wherein

the configuration of the pyranose ring is D-galacto;

X is selected from the group consisting of O, S, and SO;

Y and Z are independently selected from being CONH or a 1H-1,2,3-triazole ring;

R¹ and R² are independently selected from the group consisting of:

a) an alkyl group of at least 4 carbons, an alkenyl group of at least 4 carbons, an alkynyl group of at least 4 carbons;

b) a carbamoyl group, a carbamoyl group substituted with an alkyl group, a carbamoyl group substituted with an alkenyl group, a carbamoyl group substituted with an alkynyl group, a carbamoyl group substituted with an aryl group, a carbamoyl group substituted with an substituted alkyl group, and a carbamoyl group substituted with an substituted aryl group;

c) a phenyl group substituted with at least one carboxy group, a phenyl group substituted with at least one halogen, a phenyl group substituted with at least one alkyl group, a phenyl group substituted with at least one alkoxy group, a phenyl group substituted with at least one trifluoromethyl group, a phenyl group substituted with at least one trifluoromethoxy group, a phenyl group substituted with at least one sulfo group, a phenyl group substituted with at least one hydroxy group, a phenyl group substituted with at least one carbonyl group, and a phenyl group substituted with at least one substituted carbonyl group;

d) a naphthyl group, a naphthyl group substituted with at least one carboxy group, a naphthyl group substituted with at least one halogen, a naphthyl group substituted with at least one alkyl group, a naphthyl group substituted with at least one alkoxy group, a naphthyl group substituted with at least one sulfo group, a naphthyl group substituted with at least one hydroxy group, a naphthyl group substituted with at least one carbonyl group, and a naphthyl group substituted with at least one substituted carbonyl group;

e) a heteroaryl group, a heteroaryl group substituted with at least one carboxy group, a heteroaryl group substituted with at least one halogen, a heteroaryl group substituted with at least one alkoxy group, a heteroaryl group substituted with at least one sulfo group, a heteroaryl group substituted with at least one arylamino group, a heteroaryl group substituted with at least one hydroxy group, a heteroaryl group substituted with at least one halogen, a heteroaryl group substituted with at least one carbonyl group, and a heteroaryl group substituted with at least one substituted carbonyl group; and

f) a thienyl group, a thienyl group substituted with at least one carboxy group, a thienyl group substituted with at least one halogen, a thienyl thienyl group substituted with at least one alkoxy group, a thienyl group substituted with at least one sulfo group, a thienyl group substituted with at least one arylamino group, a thienyl group substituted with at least one hydroxy group, a thienyl group substituted with at least one halogen, a thienyl group substituted with at least one carbonyl group, and a thienyl group substituted with at least one substituted carbonyl group.

The present invention also relates to methods of treatment of galectin protein disorders in mammals, in particular humans, wherein a therapeutically effective amount of the compound according to the invention is administered to a mammal in need of the treatment. This treatment may result in inhibition of conditions associated with the binding of galectin to ligands in a mammal.

The present invention further relates to the use of the compounds according to the invention as medicaments as well as to pharmaceutical compositions comprising the compound according to the invention. Such pharmaceutical compositions normally also comprises one or more ingredients selected from the group consisting of pharmaceutically acceptable adjuvants, diluents, excepients and carriers. These medicaments and pharmaceutical compositions are suitable for treatment of any disorder relating to the binding of a galectin to ligands in a mammal.

It is possible to use only one compound according to the invention for the purposes discussed above. It is however also possible to use two or more compounds in combination.

Still further, the present invention relates to a method for inhibiting conditions associated with the binding of galectin to ligands in a mammal, which method comprises administering to said mammal an effective amount of a pharmaceutical composition mentioned above.

Galectin Specificity

The studies of galectin specificity using inhibition by small natural saccharides mentioned above indicated that all galectins bound lactose, LacNAc and related disaccharides, but that galectin-3 bound certain longer saccharides much better (Leffler and Barondes, 1986). These longer saccharides were characterized by having an additional sugar residue added to the C-3 position of Gal in lactose or LacNAc. The X-ray crystal structures of galectins-1, -2, and -3 demonstrated a highly conserved core binding site for lactose and LacNAc with features in agreement with the specificity studies (Lobsanov and Rini, 1997; Seetharaman et al., 1998). In addition, an extended groove was found, which might accommodate the added sugar residue in the longer saccharides (A-B in FIG. 1). The shape of this groove varies between galectins, suggesting that the same extensions would not be bound equally by the different galectins. Moreover, including additional galectins (e.g. galectins-4, -8 and -9) it has become clear that there is also variations in binding preference on the other side of the Gal residue (sites D-E in FIG. 1) (Leffler et al., 2004).

Design of Triazolyl- and Amido-Substituted Cyclohexyl Galactosides as Galectin Inhibitors

The extended binding site close to HO-3′ of N-acetyllactosamine (site B, FIG. 1 b) has been exploited in the design of potent galectin-3-inhibiting 3′-amido-N-actyllactosamine derivatives. (Sörme et al., 2002) In particular, aromatic amides or substituted triazole rings at C3 of galactopyranose-containing compounds made efficient inhibitors (Salameh et al., 2005; Sörme et al., 2005) by forming an energetically favorable stacking interaction with the arginine-144 guanidino group of galectin-3. (Sörme et al., 2005) Furthermore, it was demonstrated that

The presence of additional arginine residues in or close to the N-acetyllactosamine/lactose binding site of galectins suggested the design of inhibitors that make use of additional stacking interactions between aromatic groups and arginine guanidino groups to provide even more potent inhibitors. For example, the N-acetyl group of N-acetyllactosamine is, according the crystal structure of galectin-3 in complex with N-acetyllactosamine, interacting with arginine-186 of galectin-3 (FIG. 1 b). Replacing said N-acetyl group with an aromatic amido group would allow for a new stacking interaction between the aromatic amide and the arginine 186 guanidino group or with the corresponding conserved arginine residues in other galectins.

Furthermore, replacing the N-acetyllactosamine disaccharide with a hydrolytically stable mimic would add value to an inhibitor in terms of longer half-life in vivo. Thiodigalactoside was used as such a hydrolytically stable N-acetyllactosamine mimic, which is believed to bind to galectins in a manner mimicking that of N-acetyllactosamine. As N-acetyllactosamine derivatives carrying aromatic amido groups at C-3′ show high affinity for galectin-3 due to an interaction with arginine144, symmetrical thiodigalactoside derivatives carrying aromatic amides at both C-3 carbons allowed for the formation of an arene-guanidino interaction between one of the aromatic amido groups and arginine 144 (analogous to the interaction with the 3′-amido-N-acetyllactosamine derivative). The second aromatic amido group is positioned similarly to the N-acetyl group of N-acetyllactosamine, i.e. close to arginine-186 upon binding to galectin-3; that would be in site D as shown in FIG. 1 a. Henceforth, symmetrical thiodigalactoside derivatives with aromatic amides at both C-3 carbons were demonstrated to particularly potent inhibitors of several members of the galectin family of proteins with Kd values down to the low nM range (Cumpstey et a/0.2005; Cumpstey et al. 2008). Nevertheless, although displaying high affinity for galectins, the 3,3′-derivatized thiodigalactosides still comprise of two galactose monosaccharide moieties that are too polar, resulting in poor absorption and rapid clearance, and too susceptible to enzymatic degradation.

An approach towards less polar and more stable galectin inhibitors would be to replaced one or more carbohydrate residues of the inhibitors with non-saccharide structural moieties. A cyclohexane ring is such a conceptually simple pyranose mimicking structural moiety. However, if a subsite D-binding N-acetylglucosamine residue of N-acetyllactosamine is to be replaced by a cyclohexane ring, said cyclohexane ring should preferably carry a hydroxyl group capable of taking part in key hydrogen bonds (e.g. with arg162 and glu184 in galectin-3) and a substituted triazole or amide capable of interacting with conserved galectin arginine side-chains.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1. a) Schematic of the galectin carbohydrate recognition domain (CRD) (left) and carbohydrate binding sites (right) (Barondes et al., 1994; Leffler et al., 2004). The CRD is shown in face and side view with bound disaccharide symbolized by arrow or dot (left). It consists of two R-sheets named S and F. The concave side of the S-sheets forms a groove that can hold about a tetrasaccharide and has four subsites (A-D) with the defining galactose binding site as C, and a fifth subsite (E) outside the groove (top right). A bound LacNAc is shown on the S-beta sheet (bottom right) with extensions into subsite B and E. Pertinent amino acids in galectin-3 around subsite B are indicated in one letter code (grey).

FIG. 1 b) Structure of carbohydrate recognition site of galectin-3 CRD (smooth surface) with bound LacNAc (stick model). The subsites described in FIG. 1 a are indicated below the figure with Gal in site C. The arrows indicate spaces in site B targeted by derivatization on position 3 of the Gal (Sorme et al., 2002). Selected amino acids are named. The GlcNAc of the LacNAc is in site D.

FIG. 2. Mammalian galectins and their phylogeny from a prechordate ancestor (Houzelstein et al., 2004). All the CRDs are of either of two types (F4 and F3, black and grey respectively) defined by corresponding gene structure (intron-exon boundaries) and supported by their respective sequence relationships. The ancestral prechordate galectins include a bi-CRD galectin with one of each CRD type (most likely derived in much earlier evolution from duplication of a mono-CRD galectin). Large scale duplication of genome fragments in early chordate-vertebrate evolution give rise to the four major bi-CRD galectins found in mammals. Local duplication-deletion events give rise to mono-CRD galectins related to either the N- or C-terminal CRD. Some of these occurred at early more uncertain times (dotted arrows) whereas other are recent and more certain (filled arrows). Recent duplications have also produced extra copies of bi-CRD galectins in certain mammals (e.g. two extra copies of galectin-9s in humans (not shown); galectin-6 in mouse).

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS OF THE INVENTION

According to one aspect of the invention, in the above-mentioned formula, X is S or O.

According to one aspect of the invention Y and Z may both be either CONH or a 1H-1,2,3-triazole ring. Furthermore, Y may be CONH when Z is a 1H-1,2,3-triazole ring, and Y may be a 1H-1,2,3-triazole ring when Z is CONH,

When Y is CONH the CONH group may be linked via the N atom to the pyranose ring.

When Y is a 1H-1,2,3-triazole ring it may be is linked via the N1 atom to the pyranose ring. In this case, R¹ may be linked to the C4 atom of the 1H-1,2,3-triazole ring.

When Z is CONH the CONH group may be linked via the N atom to the cyclohexane.

When Z is a 1H-1,2,3-triazole ring it may be is linked via the N1 atom to the cyclohexane. In this case, R² may be linked to the C4 atom of the 1H-1,2,3-triazole ring.

According to one aspect of the invention, R¹ and R² are independently selected from the group consisting of a carbamoyl group, an alkylated carbamoyl group, an alkenylated carbamoyl group, an arylated carbamoyl group, a phenyl group, a substituted phenyl group, a halogenated phenyl group, a fluorinated phenyl group, a chlorinated phenyl group, a brominated phenyl group, an alkylated phenyl group, an alkenylated phenyl group, a trifluoromethylated phenyl group, a methoxylated phenyl group, a trifluoromethoxylated phenyl group, a naphthyl group, a substituted naphthyl group, a heteroaryl group, a substituted heteroaryl group, a thienyl group, and a substituted thienyl group.

According to another aspect either one of or both of R¹ and R² may be selected from the group consisting of an alkylated carbamoyl group, a fluorinated phenyl group, and a thienyl group.

In the present disclosure, the term “alkylated” means that the group is substituted with an alkyl group. the term “alkenylated” means that the group is substituted with an alkenyl group “alkenyl group” etc.

The term “alkyl group” is meant to comprise from 1 to 7 carbon atoms, preferably 1 to 4 carbon atoms. Said alkyl group may be straight- or branched-chain. Said alkyl group may also form a cycle comprising from 3 to 7 carbon atoms, preferably 3, 4, 5, 6, or 7 carbon atoms. Thus alkyl will mean any of methyl, ethyl, n-propyl, isopropyl, n-butyl, sec-butyl, tert-butyl, pentyl, isopentyl, 3-methylbutyl, 2,2-dimethyl propyl, n-hexyl, 2-methylpentyl, 2,2-dimethylbutyl, 2,3-dimethyl butyl, n-heptyl, 2-methylhexyl, 2,2-dimethylpentyl, 2,3-dimethylpentyl, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, and 1-methylcyclopropyl.

In the present disclosure, the term “alkenyl group” is meant to comprise from 2 to 7 carbon atoms. Said alkenyl group comprises at least one double bond. Thus alkenyl group will mean any of vinyl, allyl, but-1-enyl, but-2-enyl, 2,2-dimethylethenyl, 2,2-dimethylprop-1-enyl, pent-1-enyl, pent-2-enyl, 2,3-dimethylbut-1-enyl, hex-1-enyl, hex-2-enyl, hex-3-enyl, prop-1,2-dienyl, 4-methylhex-1-enyl, cycloprop-1-enyl group, and others.

In the present disclosure the term “aryl group” is meant to comprise from 4 to 12 carbon atoms. Said aryl group may be a phenyl group or a naphthyl group. The above-mentioned groups may naturally be substituted with any other known substituents within the art of organic chemistry. The groups may also be substituted with two or more of the said substituents. Examples of substituents are halogen, alkyl, alkenyl, alkoxy, nitro, sulfo, amino, hydroxy, and carbonyl groups. Halogen substituents are bromo, fluoro, iodo, and chloro. Alkyl groups are as defined above containing 1 to 7 carbon atoms. Alkenyl are as defined above containing 2 to 7 carbon atoms, preferably 2 to 4. Alkoxy is as defined below containing 1 to 7 carbon atoms, preferably 1 to 4 carbon atoms, which may contain an unsaturated carbon atom. Combinations of substituents can be present such as trifluoromethyl.

In the present disclosure, the term “alkoxy group” is meant to comprise from 1 to 7 carbon atoms, preferably 1 to 4 carbon atoms. Said alkoxy group may be a methoxy group, an ethoxy group, a propoxy group, a isopropoxy group, a n-butoxy group, a sec-butoxy group, tert-butoxy group, pentoxy group, isopentoxy group, 3-methylbutoxy group, 2,2-dimethylpropoxy group, n-hexoxy group, 2-methylpentoxy group, 2,2-dimethylbutoxy group 2,3-dimethylbutoxy group, n-heptoxy group, 2-methylhexoxy group, 2,2-dimethylpentoxy group, 2,3-dimethylpentoxy group, cyclopropoxy group, cyclobutoxy group, cyclopentyloxy group, cyclohexyloxy group, cycloheptyloxy group, and 1-methylcyclopropyl oxy group

In the present disclosure, the term “alkylamino group” is meant to comprise from 1 to 7 carbon atoms, preferably 1 to 4 carbon atoms, wherein the alkyl group is as defined above. Thus alkyl will mean any of methyl, ethyl, n-propyl, isopropyl, n-butyl, sec-butyl, tert-butyl, pentyl, isopentyl, 3-methylbutyl, 2,2-dimethylpropyl, n-hexyl, 2-methylpentyl, 2,2-dimethylbutyl, 2,3-dimethylbutyl, n-heptyl, 2-methylhexyl, 2,2-dimethylpentyl, 2,3-dimethylpentyl, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, and 1-methylcyclopropyl.

In the present disclosure, the term “arylamino group” is meant to comprise from 4 to 7 carbon atoms. Said “arylamino group” may be aniline, carboxylated aniline or halogenated aniline, halogen being as defined above.

In the present disclosure, the term “aryloxy group” is meant to comprise from 4 to 12 carbon atoms. Said “aryloxy group” may be phenol, carboxylated phenol or halogenated phenol, wherein halogen is as defined above.

In the present disclosure, the term “heteroaryl group” is meant to comprise any aryl group comprising from 4 to 18 carbon atoms, wherein at least one atom of the ring is a heteroatom, i.e. not a carbon. Preferably, said heteroatom is N, O or S. Said heteroaryl group may be a pyridine, or an indole group.

The above-mentioned groups may be substituted with any other known substituents within the art of organic chemistry. The groups may also be substituted with two or more of the substituents. Examples of substituents are halogen, alkoxy, nitro, sulfo, amino, hydroxy, and carbonyl groups. Halogen substituents are bromo, fluoro, iodo, and chloro. Alkyl groups are as defined above containing 1 to 7 carbon atoms. Alkenyl are as defined above containing 2 to 7 carbon atoms, preferably 2 to 4. Alkoxy is as defined below containing 1 to 7 carbon atoms, preferably 1 to 4 carbon atoms, which may contain an unsaturated carbon atom.

In one aspect of the invention, the compound is selected from the group consisting of:

-   ((1R,2R,3S)-2-hydroxy-3-(4-(N-(1-propyl)-carbamoyl)-1H-1,2,3-triazol-1-yl)cyclohexyl)     3-deoxy-β-(4-(N-(1-propyl)-carbamoyl)-1H-1,2,3-triazol-1-yl))-β-D-galactopyranoside     (7), -   ((1R,2R,3S)-2-hydroxy-3-(4-(2-fluorophenyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl)     3-deoxy-3-(4-(2-fluorophenyl)-1H-1,2,3-triazol-1-yl)-1-thio-8-D-galactopyranoside     (15), -   ((1R,2R,3S)-2-hydroxy-3-(4-β-fluorophenyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl)     3-deoxy-3-(4-β-fluorophenyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside     (16), -   ((1R,2R,3S)-2-hydroxy-3-(4-(4-fluorophenyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl)     3-deoxy-3-(4-(4-fluorophenyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside     (17), -   (1R,2R,3S)-2-hydroxy-3-(4-β-thienyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl)     3-deoxy-3-(4-β-thienyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside     (18), -   (1R,2R,3S)-2-hydroxy-3-(4-(N-(1-propyl)-carbamoyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl)     3-deoxy-3-(4-(N-(1-propyl)-carbamoyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside     (19), and -   (1R,2R,3S)-2-hydroxy-3-(4-chlorobenzamido)-cyclohexyl)     3-deoxy-3-(4-chlorobenzamido)-1-thio-β-D-galactopyranoside (22).

In one aspect, the present invention relates to the use of a compound according to the above-mentioned formula for the manufacture of a medicament for the treatment of any disorder relating to the binding of a galectin to receptors in a mammal. In one aspect of the invention, said galectin is galectin-3.

In another aspect, the invention relates to the use of a compound according to the above-mentioned formula for the manufacture of a medicament for the treatment of a disorder being selected from the group consisting of inflammation, septic shock, cancer, and autoimmune diseases such as rheumatoid arthritis and multiple sclerosis. Preferably, said compound is for the manufacture of a medicament for the treatment of cancer.

In yet another aspect, the present invention relates to a pharmaceutical composition comprising a compound according to the above-mentioned formula as active ingredient together with a pharmaceutically acceptable adjuvant, diluent, excepient or carrier. A pharmaceutical composition of the invention comprises from 1 to 99 weight % of a pharmaceutically acceptable adjuvant, diluent, excepient or carrier and from 1 to 99 weight % of a compound according to above mentioned formula.

In one aspect, the invention relates to a method for inhibiting conditions associated with the binding of galectin to receptors in a mammal which method comprises administering to said mammal, an effective amount of a compound according to the above-mentioned formula. In one particularly important aspect of the invention, said galectin is galectin-3.

In another aspect, the invention relates to a method for inhibiting conditions associated with the binding of galectin to receptors in a mammal, which method comprises administering to said mammal an effective amount of a pharmaceutical composition according to the above. In one particularly important aspect of the invention, said galectin is galectin-3.

The pharmaceutical composition according to the present invention comprising a compound of the invention may be adapted for oral, intravenous, topical, intraperitoneal, nasal, buccal, sublingual, or subcutaneous administration, or for administration via the respiratory tract in the form of, for example, an aerosol or an air-suspended fine powder. Therefore, the pharmaceutical composition of the present invention may be in the form of, for example, tablets, capsules, powders, solutions, transdermal patches or suppositories.

The pharmaceutical composition of the present invention may optionally comprise two or more compounds of the present invention. The composition may also be used together with other medicaments within the art for the treatment of related disorders.

The typical dosages of the compounds of the present invention vary within a wide range and depend on many factors, such as the route of administration, the requirement of the individual in need of treatment, the individual's body weight, age and general condition.

The adjuvants, diluents, excepients and/or carriers that may be used in the composition of the invention must be pharmaceutically acceptable in the sense of being compatible with the compounds and the other ingredients of the pharmaceutical composition, and not deleterious to the recipient thereof. The adjuvants, diluents, excepients and carriers that may be used in the pharmaceutical composition of the invention are well known to a person within the art.

Synthesis of Triazolyl- and Amido-Substituted Cyclohexyl Galactosides

The triazolyl- and amido-substituted cyclohexyl galactosides were synthesized from known (US2008200406) chiral cyclohexen oxide ((1R,2R,6R)-2-(triphenylmethoxy)-7-oxabicyclo[4.1.0]heptane) (1) and methyl 2,4,6-tri-O-acetyl-3-azido-3-deoxy-1-thio β-D galactopyranoside (Sorme et al., 2002) as shown in schemes 1-3.

CuI, DIPEA, toluene (44-93%); d) NaOMe (0.05 M in MeOH) (53-85%); e) n-Propylamine, MeOH.

TABLE 1 R structures of scheme 2 c) d) e) R in structure Alkyne in of yield yield yield of scheme 2 scheme 2 (%) (%) (%) Orto- 1-ethynyl-orto- 93 (10) 55 (15) fluorophenyl fluorobenzene Meta- 1-ethynyl-meta- 66 (11) 83 (16) fluorophenyl fluorobenzene Para- 1-ethynyl-para- 44 (12) 85 (17) fluorophenyl fluorobenzene 3-thienyl 3-ethynyl thiophene 88 (13) 53 (18) N-(1-Propyl)- Methyl propiolate 100 (14) 68 (19) carbamoyl

Evaluation of K_(d) Values Against Galectin-3

Compounds 7, 15-19, and 22 were evaluated for their efficiency in inhibiting galectin-1 and galectin-3 (Table 2) in a known fluorescence polarization-based assay (Sörme et al., 2003a, 2004). The known galectin inhibitors galactose and N-acetyllactosamine methyl glycosides were included as reference compounds. Indeed, all compounds were potent inhibitors of galectin-1 and galectin-3 with dissociation constant in the low μM or nM range. This evidences that a properly structured cyclohexane can mimic the subsite D-binding saccharide moiety, e.g. N-acetylglucosamine in the disaccharide N-acetyllactosamine. In particular, substituted (1R,2R,3S)-2-hydroxy-3-(1H-1,2,3-triazol-1-yl)-cyclohexyl) β-D-galactopyranosides and (1R,2R,3S)-2-hydroxy-3-(amido)-cyclohexyl) β-D-galactopyranosides are capable of such mimicking, as are their corresponding thioglycosides. Hence, combining said (1R,2R,3S)-2-hydroxy-3-(1H-1,2,3-triazol-1-yl)-cyclohexyl) β-D-galactopyranosides and (1R,2R,3S)-2-hydroxy-3-(amido)-cyclohexyl) β-D-galactopyranosides with galactose C3 triazoles or aromatic amides results in potent galectin inhibitors several order of magnitude better than know reference inhibitors.

The unexpectedly high inhibitor potency, suitable polarity, and stability of said substituted cyclohexyl galactosides against galectin-3 render them suitable to be active components in pharmaceutical compositions targeting conditions where galectin-3 plays a pathogenic role.

TABLE 2 Affinity of compounds for galectin-1 and galectin-3 as calculated from test by fluorescence polarization. Galectin-1 Galectin-3 Tested Calcu- Tested Calcu- Conc. lated K_(d) Conc. lated K_(d) Structure (μM) (μM) (μM) (μm) Reference compound

20000 >10000 10000 4400 Reference compound

200 65 200 59  7

— — 1 0.43 15

2 1.9 1 0.23 16

2 1.5 1 0.15 17

2 1.2 1 0.21 18

2 0.35 1 0.55 19

2 1.3 0.5 0.19 23

10 6.3 4 1.4

Methodology/Experimental General Synthetic Procedures

The compounds of this invention may be prepared by the following general methods and procedures. The galectin-3 assays of this invention may be performed by the following general methods and procedures. It should be appreciated that where typical or preferred process conditions (e.g. reaction temperatures, times, molar ratios of reactants, solvents, pressures, pH etc) are given, other process conditions may also be used unless otherwise stated. Optimum reaction conditions may vary with the particular reactants, solvents used and pH etc., but such conditions can be determined by one skilled in the art by routine optimization procedures.

Identification of the substances was made by HRMS (Micromass Q-tof micro) and NMR (Bruker Ultrashield 400 plus, 400 MHz). Chemical shifts are reported downfield from Me₄Si using residual CHD₂Cl (7.26 ppm) or CHD₂OD (3.35 ppm) as reference. Chemical shifts and coupling constants were obtained from ¹H-NMR and proton resonances were assigned from COSY experiments. Purification was made by RF-HPLC (Beckman, system gold) or flash chromatography, using silica gel (Davisil 35-70 μm, 60 Å). Reactions were followed by TLC (Aluminum sheet, silica gel 60 F254) observed by UV light, H₂SO₄(aq) or a iso-vanillin/H₂SO₄/EtOH solution. THF and Et₂O were dried over sodium/benzophenone and distilled. CH₂Cl₂ was dried by molecular sieves (4 Å, 1.6 mm). Other solvents and reagents were commercially available and used without further purifications. Fluorescence polarization experiments were performed on a PolarStar instrument (BMG, Offenburg; Germany). Evaluation of 7, 15-19, and 22 as inhibitors of galectins was performed by use of fluorescence polarization as described in the literature (Sorme et al., 2003a, 2004).

(1R,2S,6R)-2-azido-6-(trityloxy)cyclohexanol (2)

The diastereomeric mixture of (1R,2R,6R)-2-(triphenylmethoxy)-7-oxabicyclo[4.1.0]heptane 1 (755 mg, 2.12 mmol) and the S,S-epoxide was dissolved with NaN₃ (861 mg, 13.3 mmol) in H₂O (1.7 mL) and MeOH (15 mL). The mixture was heated to 80° C., refluxed over night and then diluted with water and CH₂Cl₂. The organic layer was separated and the aqueous layer was rewashed (CH₂Cl₂). The entire organic layer was dried (MgSO₄), filtered and concentrated. Purification was made by recrystallization in MeOH at −18° C. The reaction yielded 62% of 2. ¹H-NMR (CDCl₃) 7.50 (m, 6H), 7.20-7.40 (m, 9H), 3.69 (t, J=9.50 Hz, 1H), 3.05 (ddd, J=4.80, 9.44, 12.05 Hz, 1

H), 2.91 (ddd, J=4.17, 8.81, 11.28 Hz, 1H), 2.70 (s, 1H), 1.80 (m, 1H), 1.50 (m, 2H), 1.20-1.40 (m, 2H), 0.80 (m, 1H).

(1R,2S,6R)-2-azido-6-(trityloxy)cyclohexyl acetate (3)

Compound 2 (625 mg, 1.57 mmol), pyridine (363 μL, 4.69 mmol) and AcCl (272 μL, 3.13 mmol) were dissolved in CH₂Cl₂ (15 mL) under nitrogen atmosphere at room temperature. After 2 h the mixture was diluted with CH₂Cl₂. The organic layer was washed (HCl(aq) 5%, sat NaHCO₃, brine), dried (MgSO₄), filtered and concentrated. No further purification was needed. The reaction yielded 100% of 3. ¹H-NMR (CDCl₃) 7.45 (m, 6H), 7.20-7.35 (m, 9H), 5.14 (t, J=9.49 Hz, 1H), 2.99-3.10 (m, 2H), 1.93 (s, 3H), 1.86 (m, 1H), 1.50 (m, 2H), 1.25-1.40 (m, 2H), 0.80 (m, 1H).

(1R,2S,6R)-2-azido-6-hydroxycyclohexyl acetate (4)

Compound 3 (677 mg, 1.53 mmol) was dissolved in AcOH (10 mL), heated to 56° C. and left over night. The mixture was concentrated and purified by flash chromatography using EtOAc:n-heptan (1:1) as eluent. The reaction yielded 81% of 4. ¹H-NMR (CDCl₃) 4.72 (t, J=9.54 Hz, 1H), 3.56 (m, 1H), 3.47 (m, 1H), 2.19 (s, 3H), 2.00-2.10 (m, 3H), 1.80 (m, 1H), 1.25-1.45 (m, 3H). HRMS calculated mass (C₈H₁₄N₃O₃ ⁺): 200.1030, observed mass: 200.1056.

((1R,2R,3S)-2-acetoxy-3-azidocyclohexyl) 2,4,6-tri-O-acetyl-3-azido-3-deoxy β-D-galactopyranoside (5)

Compound 4 (29.5 mg, 147 μmol), methyl 2,4,6-tri-O-acetyl-3-azido-3-deoxy-1-thio-β-D-galactopyranoside (63.7 mg, 178 μmol) and activated molecular sieves AW300 was stirred under nitrogen at room temperature. for 30 min before it was cooled to −42° C. N-iodosuccinimide (49.5 mg, 221 μmol) and TfOH (1.91 μL, 22.1 μmol) was added. After 4 h the reaction was heated to −18° C. left over night and then heated to room temperature, filtered and diluted with CH₂Cl₂. The organic layer was washed (Na₂S₂O₃(aq)), dried (MgSO₄), filtered and concentrated. Purification was made by flash chromatography using acetone:toluene (1:10) as eluent. The reaction yielded 6.1% of 5. ¹H-NMR (CDCl₃) 5.42 (dd, J=0.99, 3.40 Hz, 1H), 5.06 (dd, J=7.75, 10.72 Hz, 1H), 5.33 (t, J=9.55 Hz, 1H), 4.48 (d, J=7.82 Hz, 1H), 4.10 (m, 2H), 3.85 (dt, J=1.19, 6.71 Hz, 1H), 3.62 (m, 1H), 3.54 (dd, J=3.41, 10.65 Hz, 1H), 3.36 (m, 1H), 2.19 (s, 3H), 2.12 (s, 3H), 2.11 (s, 3H), 2.08 (s, 3H), 2.00-2.10 (m, 2H), 1.81 (m, 1H), 1.25-1.45 (m, 3H). HRMS calculated mass (C₂₀H₂₈N₆NaO₁₀ ⁺): 535.1759, observed mass: 535.1776.

((1R,2R,3S)-2-acetoxy-3-(4-(methoxycarbonyl)-1H-1,2,3-triazol-1-yl)cyclohexyl) 2,4,6-tri-O-acetyl-3-deoxy-β-(4-(methoxycarbonyl)-1H-1,2,3-triazol-1-yl)) β-D-galactopyranoside (6)

Compound 5 (8 mg, 15.7 μmol), methylpropionate (2.78 μL, 31.2 μmol), CuI (595 μg, 3.12 μmol) and diisopropylethylamine (5.35 μL, 31.2 μmol) were dissolved in toluene (1 mL), heated to 45° C. and left over night. The mixture was concentrated and purified by flash chromatography using EtOAc as eluent. The reaction yielded 44% of 6. ¹H-NMR (CDCl₃) 8.15 (s, 1H), 8.14 (s, 1H), 5.50 (m, 2H), 5.15-5.20 (m, 2H), 4.71 (d, J=7.53 Hz, 1H), 4.65 (m, 1H), 4.10 (m, 3H), 3.96 (s, 3H), 3.95 (s, 3H), 2.28 (m, 1H), 2.18 (m, 1H), 2.08 (s, 3H), 2.06 (s, 3H), 1.95-2.10 (m, 3H), 1.91 (s, 6H), 1.50 (m, 2H). HRMS calculated mass (C₂₈H₃₆N₆NaO₁₄ ⁺): 703.2182, observed mass: 703.2201.

((1r,2r,3s)-2-hydroxy-3-(4-(N-(1-propyl)-carbamoyl)-1h-1,2,3-triazol-1-yl)cyclohexyl) 3-deoxy-β-(4-(N-(1-propyl)-carbamoyl)-1h-1,2,3-triazol-1-yl))-β-D-galactopyranoside (7)

Compound 6 (5 mg, 7.37 μmol) was dissolved in MeOH:propylamine

(5:1, 2.4 mL) and left over night at room temperature. The mixture was concentrated and purified by flash chromatography using MeOH:CH₂Cl₂ (1:9) as eluent. The reaction yielded 53% of 7. Further purification was made by reverse-phase HPLC using a linear gradient of H₂O:MeCN (100%->0% H₂O) as eluent. ¹H-NMR (CDCl₃) 8.42 (s, 1H), 8.39 (s, 1H), 4.64 (d, J=7.47 Hz, 1H), 4.49 (ddd, J=4.63, 8.95, 12.17 Hz, 1H), 4.13 (dd, J=7.50, 11.14 Hz, 1H), 4.04 (d, J=2.63 Hz, 1H), 3.73-3.90 (m, 4H), 3.68 (dd, J=4.82, 11.17 Hz, 1H), 3.36 (t, J=7.15 Hz, 4H), 2.25 (m, 1H), 2.00-2.20 (m, 2H), 1.91 (m, 1H), 1.62 (m, 4H), 1.55 (m, 2H), 0.98 (t, J=7.4, 6 H). HRMS calculated mass (C₂₄H₃₉N₈O₈ ⁺): 567.2885, observed mass: 567.2894.

(1R,2S,6S)-2-azido-6-hydroxycyclohexyl acetate (8)

To a solution of 4 (416 mg, 2.09 mmol) and pyridine (506 μL, 6.27 mmol) in CH₂Cl₂ (10 mL), Tf₂O (421 μL, 2.51 mmol) was dropwise added at −10° C. The mixture was left to react for 10 min when it was diluted (CH₂Cl₂), washed (HCl(aq) 5%, NaHCO₃(aq) sat, brine), dried (MgSO₄), filtered and concentrated. The crude was then dissolved in DMF (20 mL). Bu₄NNO₂ (1810 mg, 6.27 mmol) was added and the mixture was heated to 50° C. After 1 h the mixture was cooled to room temperature. and concentrated. Purification was made by flash chromatography using EtOAc:n-heptan (1:1) as eluent. The reaction yielded 64% of 8. ¹H-NMR (CDCl₃) 4.79 (dd, J=4.78, 9.75 Hz, 1H), 4.17 (m, 1H), 3.83 (ddd, J=4.58, 9.84, 11.29 Hz, 1H), 2.18 (s, 3H), 2.00-2.10 (m, 1H), 1.85-1.95 (m, 1H), 1.70-1.80 (m, 1H), 1.50-1 65 (m, 2H), 1.30-1.45 (m, 1H)

((1R,2R,3S)-2-acetoxy-3-azidocyclohexyl) 2,4,6-tri-O-acetyl-3-azido-3-deoxy 1-thio-β-D-galactopyranoside (9)

To a solution of 8 (64.5 mg, 324 μmol) and pyridine (78.6 μL, 973 μmol) in CH₂Cl₂ (1.7 mL), was added dropwise Tf₂O (65.4 μL, 389 μmol) at −10° C. The mixture was left to react for 1 h when it was diluted (CH₂Cl₂), washed (HCl(aq) 5%, NaHCO₃(aq) sat, brine), dried (MgSO₄), filtered and concentrated. The crude was coevaporated in toluene with methyl 2,4,6-tri-O-acetyl-3-azido-3-deoxy-1-thio-β-D-galactopyranoside (Sorme et al. 2002) (108 mg, 311 μmol) and CH₂Cl₂ (3.2 mL) was added. The mixture was degassed and Et₃N (65.0 μL, 467 μmol) was added. The mixture was left to react for 16 h when it was diluted (CH₂Cl₂), washed (HCl(aq) 5%, brine), dried (MgSO₄), filtered and concentrated. Purification was made by flash chromatography using EtOAc:n-heptan (2:3) as eluent. The reaction yielded 43% of 9. ¹H-NMR (CDCl₃) 5.46 (dd, J=1.10, 3.50 Hz, 1H), 5.12 (t, J=10.07 Hz, 1H), 4.82 (dd, J=9.45, 10.54 Hz, 1H), 4.70 (d, J=9.95 Hz, 1H), 4.10 (d, J=6.61 Hz, 2H), 3.89 (t, J=6.10 Hz, 1H), 3.67 (dd, J=3.33, 9.77 Hz, 1H), 3.35-3.45 (m, 1H), 2.77-2.87 (m, 1H), 2.18 (s, 1H), 2.15 (s, 3H), 2.14 (s, 3H), 2.06 (s, 3H).

((1R,2R,3S)-2-acetoxy-3-(4-(2-fluorophenyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl) 2,4,6-tri-O-acetyl-3-deoxy-3-(4-(2-fluorophenyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside (10)

Compound 9 (8.80 mg, 16.7 μmol), 1-ethynyl-2-fluorobenzene (5.67 μL, 50.0 μmol), CuI (0.634 mg, 5.00 μmol) and DIPEA (8.55 μL, 50.0 μmol) was dissolved in toluene (1 mL). The mixture was heated to 45° C. and left to react for 22 h when it was diluted (CH₂Cl₂), washed (HCl(aq) 5%, brine), dried (MgSO₄), filtered and concentrated. Purification was made by flash chromatography using EtOAc:n-heptan (3:2) as eluent. The reaction yielded 93% of 10.

In the same way compounds 11-13 were prepared:

((1R,2R,3S)-2-acetoxy-3-(4-β-fluorophenyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl) 2,4,6-tri-O-acetyl-3-deoxy-3-(4-β-fluorophenyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside (11)

¹H-NMR (CDCl₃) 7.86 (s, 1H), 7.81 (s, 1H), 7.48-7.63 (m, 4H), 7.35-7.45 (m, 2H), 7.70-7.10 (m, 2H), 5.70 (dd, J=9.74, 10.83 Hz, 1H), 5.62 (d, J=3.24 Hz, 1H), 5.26 (t, J=10.38 Hz, 1H), 5.20 (dd, J=3.25, 10.97 Hz, 1H), 4.92 (d, J=9.58 Hz, 1H), 4.63-4.73 (m, 1H), 4.10-4.25 (m, 3H), 3.05-3.15 (m, 1H), 2.30-2.50 (m, 2H), 2.00-2.20 (m, 2H), 2.09 (s, 3H), 2.09 (s, 3H), 1.80-1.90 (m, 1H), 1.90 (s, 3H), 1.88 (s, 3H), 1.60-1.70 (m, 1H)

((1R,2R,3S)-2-acetoxy-3-(4-(4-fluorophenyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl) 2,4,6-tri-O-acetyl-3-deoxy-3-(4-(4-fluorophenyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside (12)

¹H-NMR (CDCl₃) 7.70-7.85 (m, 6H), 7.05-7.15 (m, 4H), 5.70 (t, J=10.20 Hz, 1H), 5.62 (d, J=2.36 Hz, 1H), 5.26 (t, J=10.30 Hz, 1H), 5.20 (d, J=10.44 Hz, 1H), 4.92 (d, J=9.46 Hz, 1H), 4.63-4.73 (m, 1H), 4.10-4.25 (m, 3H), 3.05-3.15 (m, 1H), 2.30-2.50 (m, 2H), 2.00-2.20 (m, 2H), 2.09 (s, 3H), 2.08 (s, 3H), 1.80-1.90 (m, 1H), 1.89 (s, 3H), 1.87 (s, 3H), 1.60-1.70 (m, 1H)

((1R,2R,3S)-2-acetoxy-3-(4-β-thiopheneyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl) 2,4,6-tri-O-acetyl-3-deoxy-3-(4-β-thienyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside (13)

¹H-NMR (CDCl₃) 7.74 (s, 1H), 7.65-7.70 (m, 3H), 7.42-7.46 (m, 1H), 7.35-7.42 (m, 3H), 5.70 (dd, J=9.72, 10.84 Hz, 1H), 5.61 (d, J=3.20 Hz, 1H), 5.25 (t, J=10.40 Hz, 1H), 5.19 (dd, J=3.26, 11.06 Hz, 1H), 4.91 (d, J=9.64 Hz, 1H), 4.63-4.73 (m, 1H), 4.10-4.25 (m, 3H), 3.05-3.15 (m, 1H), 2.30-2.50 (m, 2H), 2.00-2.20 (m, 2H), 2.09 (s, 3H), 2.08 (s, 3H), 1.80-1.90 (m, 1H), 1.89 (s, 3H), 1.87 (s, 3H), 1.60-1.70 (m, 1H)

((1R,2R,3S)-2-hydroxy-3-(4-(2-fluorophenyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl) 3-deoxy-3-(4-(2-fluorophenyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside (15)

Compound 10 (12.0 mg, 15.6 μmol) was dissolved in NaOMe (0.05 M, 1 mL). After 21 h the mixture was neutralized (Duolite C436) and concentrated. Purification was made by reverse-phase HPLC using a linear gradient of H₂O:MECN (100%->0% H₂O). The reaction yielded 55% of 15. ¹H-NMR (MeOD) 8.38 (d, J=3.53 Hz, 1H), 8.35 (d, J=3.55 Hz, 1H), 8.08-8.18 (m, 2H), 7.33-7.43 (m, 2H), 7.18-7.33 (m, 4H), 4.92 (dd, 1H), 4.76 (d, 9.48 Hz, 1H), 4.47-4.57 (m, 1H), 4.28 (dd, J=9.51, 10.55 Hz, 1H), 4.15 (d, J=2.98 Hz, 1H), 3.83-3.93 (m, 2H), 3.76 (dd, J=6.87, 11.35 Hz, 1H), 3.68 (dd, J=5.19, 11.37 Hz, 1H), 3.07-3.17 (m, 1H), 2.28-2.38 (m, 1H), 2.08-2.25 (m, 2H), 1.90-2.00 (m, 1H), 1.60-1.77 (m, 2H).

In the same way compounds 16-18 were prepared:

((1R,2R,3S)-2-hydroxy-3-(4-β-fluorophenyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl) 3-deoxy-3-(4-β-fluorophenyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside (16)

¹H-NMR (MeOD) 8.50 (s, 1H), 8.47 (s, 1H), 7.55-7.70 (m, 4H), 7.40-7.50 (m, 2H), 7.03-7.13 (m, 2H), 4.89 (dd, 1H), 4.77 (d, 9.48 Hz, 1H), 4.47-4.57 (m, 1H), 4.30 (t, J=10.03 Hz, 1H), 4.14 (d, J=2.87 Hz, 1H), 3.83-3.93 (m, 2H), 3.77 (dd, J=6.77, 11.31 Hz, 1H), 3.69 (dd, J=5.15, 11.24 Hz, 1H), 3.07-3.17 (m, 1H), 2.28-2.38 (m, 1H), 2.08-2.25 (m, 2H), 1.90-2.00 (m, 1H), 1.60-1.77 (m, 2H).

((1R,2R,3S)-2-hydroxy-3-(4-(4-fluorophenyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl) 3-deoxy-3-(4-(4-fluorophenyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside (17)

¹H-NMR (MeOD) 8.42 (s, 1H), 8.38 (s, 1H), 7.75-7.95 (m, 4H), 7.10-7.25 (m, 4H), 4.89 (dd, 1H), 4.77 (d, 9.47 Hz, 1H), 4.47-4.57 (m, 1H), 4.29 (dd, J=9.77, 10.33 Hz, 1H), 4.14 (d, J=2.73 Hz, 1H), 3.83-3.93 (m, 2H), 3.77 (dd, J=6.81, 11.34 Hz, 1H), 3.69 (dd, J=5.24, 11.27 Hz, 1H), 3.07-3.17 (m, 1H), 2.28-2.38 (m, 1H), 2.08-2.25 (m, 2H), 1.90-2.00 (m, 1H), 1.60-1.77 (m, 2H).

((1R,2R,3S)-2-hydroxy-3-(4-β-thiopheneyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl) 3-deoxy-3-(4-β-thienyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside (18)

¹H-NMR (MeOD) 8.44 (s, 1H), 8.31 (s, 1H), 7.70-7.83 (m, 2H), 7.40-7.65 (m, 4H), 4.85 (dd, 1H), 4.76 (d, 9.46 Hz, 1H), 4.47-4.57 (m, 1H), 4.28 (dd, J=9.53, 10.50 Hz, 1H), 4.14 (d, J=2.95 Hz, 1H), 3.83-3.93 (m, 2H), 3.77 (dd, J=6.79, 11.35 Hz, 1H), 3.69 (dd, J=5.17, 11.35 Hz, 1H), 3.07-3.17 (m, 1H), 2.28-2.38 (m, 1H), 2.08-2.25 (m, 2H), 1.90-2.00 (m, 1H), 1.60-1.77 (m, 2H).

((1R,2R,3S)-2-hydroxy-3-(4-(propylcarbamoyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl)-3-deoxy-3-(4-(propylcarbamoyl)-1H-1,2,3-triazol-1-yl)-thio-β-D-galactopyranoside (19)

The compound ((1R,2R,3S)-2-acetoxy-3-(4-(methoxycarbonyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl)-3-deoxy-3-(4-(methoxycarbonyl)-1H-1,2,3-triazol-1-yl)-thio-β-D-galactopyranoside (2,4,6)-triacetate (14) was prepared following the procedure described above for compound (6). Compound 14 was dissolved in MeOH (2.0 mL) and propylamine (400 μl). After 16 h, the mixture was concentrated and purified by reverse-phase HPLC (linear gradient of H₂O:MeCN 100%->0% H₂O) to give 19 (68%). ¹H-NMR (CDCl₃) 8.46 (s, 1H), 8.40 (s, 1H), 4.73 (d, J=9.5 Hz, 1H), 4.50 (ddd, J=4.6, 9.0, 12.2 Hz, 1H), 4.21 (dd, J=9.5, 10.0 Hz, 1H), 4.09 (br d, J=2.6 Hz, 1H), 3.63-3.86 (m, 4H), 3.08 (m, 1H), 2.30 (m, 1H), 2.08-2.23 (m, 2H), 1.95 (m, 1H), 1.62 (m, 6H), 1.55 (m, 2H), 0.98 (t, J=7.5 Hz, 6H).

((1R,2R,3S)-2-hydroxy-3-(4-chlorobenzamido)-cyclohexyl)-3-deoxy-3-(4-chlorobenzamido)-thio-β-D-galactopyranoside (22)

Compound 9 (135 mg, 0.263 mmol) was dissolved in DCM (500 μl). NaOMe (500 μl, 0.05 M in MeOH) was added and the mixture was stirred over night. The mixture was neutralized (Duolite C436/H⁺), filtered and concentrated to give ((1R,2R,3S)-2-hydroxy-3-azidocyclohexyl)-3-deoxy-3-azido-thio-β-D-galactopyranoside (20). A portion of the crude compound 20 (5.0 mg, 13.9 μmol) was dissolved in THF (800 μL) and water (800 μL). PMe₃ (139 μmol, 139 μL, 1M in THF) was added. After 1 h, the mixture was concentrated to give ((1R,2R,3S)-2-hydroxy-3-aminocyclohexyl)-3-deoxy-3-amino-thio-β-D-galactopyranoside (21). The crude compound 21 was dissolved in DCM (550 μL) and water (550 μL). 4-Chloro benzoylchloride (30.5 μmol, 3.9 μL) and Na₂CO₃ (14.7 mg, 139 μmol) was added and the mixture was stirred for 1 h. Concentration and flash chromatography (5 g SiO₂, EtOAc), and finally reverse-phase HPLC (linear gradient of H₂O:MeCN 100%->0% H₂O) gave 22 (0.91 mg, 16% from 9). ¹H-NMR (CDCl₃) 7.85 (m, 4H), 7.48 (m, 4H), 4.58 (d, J=10.0 Hz, 1H), 4.13 (dd, J=2.8, 10.0 Hz, 1H), 4.03 (d, J=3.2 Hz, 1H), 3.94 (m, 1H), 3.82 (t, J=10.0 Hz, 1H), 3.77-3.64 (m, 3H), 3.42 (t, J=10.0 Hz, 1H), 2.97 (m, 1H), 2.23 (m, 1H), 2.00 (m, 1H), 1.80 (m, 1H), 1.60-1.23 (m, 3H).

Examples of In Vivo Efficacy of Galectin Inhibition in Inflammation and Cancer Inflammation

As mentioned above, many studies suggest a role for galectin-3 in enhancement of the inflammatory response. For example, the addition of galectin-3 to neutrophil leukocytes from an inflammatory site, or primed by exposure to LPS, results in increased generation of toxic oxygen radicals. Lactose can inhibit this response (Karlsson et al., 1998; Almquist et al., 2001). In another study (Sano et al., 2000), galectin-3 was found to be chemotactic to macrophages and monocytes, both in vitro and in vivo. Either lactose or the isolated CRD of galectin-3 (galectin 3C), able to bind the same saccharide receptor as galectin-3 but not cross link it (see below), acted as inhibitors of this response. The substances described in the present invention would be much more effective as inhibitors of the above mentioned responses than lactose because they are much more potent galectin-3 inhibitors. They would also be much more useful in vivo than lactose and the galectin-3C because they are small molecules, more hydrophobic and probably more stable to degradation.

Cancer

As mentioned above, several studies of models of human cancer in mice indicate that enhanced expression of galectin-3 results in faster tumor growth and more metastasis (Bresalier et al., 1998; reviewed by Leffler, 2001 and Takenaka et al in Leffler (editor), 2004b). Injection of a saccharide with inhibitory potency to galectin-3, but perhaps also other proteins, was reported to diminish prostate cancer in rat (Pienta et al., 1995). Hence, potent small-molecule inhibitors of galectin-3 are expected to have similar anticancer effects as galectin-3C (John et al., 2003).

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1-31. (canceled)
 32. A method for treatment of a galectin protein disorder in a mammal, wherein said disorder is selected from the group consisting of inflammation, fibrosis, septic shock, cancer, autoimmune diseases, rheumatoid arthritis and multiple sclerosis, the method comprising administering to said mammal a therapeutically effective amount of a compound of the general formula (I):

wherein the configuration of the pyranose ring is D-galacto; X is selected from the group consisting of O, S, and SO; Y and Z are independently selected from being CONH or a 1H-1,2,3-triazole ring; R¹ and R² are independently selected from the group consisting of: a) an alkyl group of at least 4 carbons, an alkenyl group of at least 4 carbons, an alkynyl group of at least 4 carbons; b) a carbamoyl group, a carbamoyl group substituted with an alkyl group, a carbamoyl group substituted with an alkenyl group, a carbamoyl group substituted with an alkynyl group, a carbamoyl group substituted with an aryl group, a carbamoyl group substituted with a substituted alkyl group, and a carbamoyl group substituted with a substituted aryl group; c) a phenyl group substituted with at least one carboxy group, a phenyl group substituted with at least one halogen, a phenyl group substituted with at least one alkyl group, a phenyl group substituted with at least one alkoxy group, a phenyl group substituted with at least one trifluoromethyl group, a phenyl group substituted with at least one trifluoromethoxy group, a phenyl group substituted with at least one sulfo group, a phenyl group substituted with at least one hydroxy group, a phenyl group substituted with at least one carbonyl group, and a phenyl group substituted with at least one substituted carbonyl group; d) a naphthyl group, a naphthyl group substituted with at least one carboxy group, a naphthyl group substituted with at least one halogen, a naphthyl group substituted with at least one alkyl group, a naphthyl group substituted with at least one alkoxy group, a naphthyl group substituted with at least one sulfo group, a naphthyl group substituted with at least one hydroxy group, a naphthyl group substituted with at least one carbonyl group, and a naphthyl group substituted with at least one substituted carbonyl group; e) a heteroaryl group, a heteroaryl group substituted with at least one carboxy group, a heteroaryl group substituted with at least one halogen, a heteroaryl group substituted with at least one alkoxy group, a heteroaryl group substituted with at least one sulfo group, a heteroaryl group substituted with at least one arylamino group, a heteroaryl group substituted with at least one hydroxy group, a heteroaryl group substituted with at least one halogen, a heteroaryl group substituted with at least one carbonyl group, and a heteroaryl group substituted with at least one substituted carbonyl group; and f) a thienyl group, a thienyl group substituted with at least one carboxy group, a thienyl group substituted with at least one halogen, a thienyl thienyl group substituted with at least one alkoxy group, a thienyl group substituted with at least one sulfo group, a thienyl group substituted with at least one arylamino group, a thienyl group substituted with at least one hydroxy group, a thienyl group substituted with at least one halogen, a thienyl group substituted with at least one carbonyl group, and a thienyl group substituted with at least one substituted carbonyl group.
 33. The method according to claim 32, Y is selected from CONH and a 1H-1,2,3-triazole ring.
 34. The method according to claim 33, wherein the CONH group is linked via the N atom to the pyranose ring.
 35. The method according to claim 33, the 1H-1,2,3-triazole ring is linked via the N1 atom to the pyranose ring.
 36. The method according to claim 32, wherein Z is selected from CONH and a 1H-1,2,3-triazole ring.
 37. The method according to claim 36, wherein the CONH group is linked via the N atom to the pyranose ring.
 38. The method according to claim 36, wherein the 1H-1,2,3-triazole ring is linked via the N1 atom to the pyranose ring.
 39. The method according to claim 32, wherein R¹ is linked to the C4 atom of the 1H-1,2,3-triazole ring.
 40. The method according to claim 32, R² is linked to the C4 atom of the 1H-1,2,3-triazole ring.
 41. The method according to claim 32, wherein R¹ and R² are independently selected from the group consisting of a carbamoyl group, an alkylated carbamoyl group, an alkenylated carbamoyl group, an arylated carbamoyl group, a phenyl group, a substituted phenyl group, a halogenated phenyl group, a fluorinated phenyl group, a chlorinated phenyl group, a brominated phenyl group, an alkylated phenyl group, an alkenylated phenyl group, a trifluoromethylated phenyl group, a methoxylated phenyl group, a trifluoromethoxylated phenyl group, a naphthyl group, a substituted naphthyl group, a heteroaryl group, a substituted heteroaryl group, a thienyl group, and a substituted thienyl group.
 42. The method according to claim 32, wherein) R¹ is an alkylated carbamoyl group, a fluorinated phenyl group, or a thienyl group.
 43. The method according to claim 32, wherein R² is an alkylated carbamoyl group, a fluorinated phenyl group, or a thienyl group.
 44. The method according to claim 32, X is O or S.
 45. The method according to claim 32, wherein said compound is selected from the group consisting of: ((1R,2R,3 S)-2-hydroxy-3-(4-(N-(1-propyl)-carbamoyl)-1H-1,2,3-triazol-1-yl)cyclohexyl) 3-deoxy-β-(4-(N-(1-propyl)-carbamoyl)-1H-1,2,3-triazol-1-yl))-β-D-galactopyranoside, ((1R,2R,3 S)-2-hydroxy-3-(4-(2-fluorophenyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl) 3-deoxy-3-(4-(2-fluorophenyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside, ((1R,2R,3 S)-2-hydroxy-3-(4-β-fluorophenyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl) 3-deoxy-3-(4-β-fluorophenyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside, ((1R,2R,3 S)-2-hydroxy-3-(4-(4-fluorophenyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl) 3-deoxy-3-(4-(4-fluorophenyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside, (1R,2R,3 S)-2-hydroxy-3-(4-(3-thienyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl) 3-deoxy-3-(4-(3-thienyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside, (1R,2R,3S)-2-hydroxy-3-(4-(N-(1-propyl)-carbamoyl)-1H-1,2,3-triazol-1-yl)-cyclohexyl) 3-deoxy-3-(4-(N-(1-propyl)-carbamoyl)-1H-1,2,3-triazol-1-yl)-1-thio-β-D-galactopyranoside, and (1R,2R,3S)-2-hydroxy-3-(4-chlorobenzamido)-cyclohexyl) 3-deoxy-3-(4-chlorobenzamido)-1-thio-β-D-galactopyranoside.
 46. The method according to claim 32, wherein the compound of the general formula (I) is adapted for oral, intravenous, topical, intraperitoneal, nasal, buccal, sublingual, or subcutaneous administration, or for administration via the respiratory tract.
 47. The method according to claim 46, wherein the compound of the general formula (I) is in the form of a tablet, a capsule, a powder, a solution, a transdermal patch or a suppository. 